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Kenneth D. Common, O.d., P.s.
Clinic/Center in Olympia, Washington
NPI 1811052798

Kenneth D. Common, O.d., P.s. is a Clinic/Center based in Olympia, WA. Kenneth D. Common, O.d., P.s. practices in Olympia, WA. The NPI Number for Kenneth D. Common, O.d., P.s. is 1811052798 and holds a License No. 1155 (Washington).

The current practice location address for Kenneth D. Common, O.d., P.s. is 625 Black Lake Blvd Sw, Olympia, WA and can be reached out via phone at 360-357-2544 and via fax at 360-357-6341. You can also correspond with Kenneth D. Common, O.d., P.s. through the mailing address at 625 BLACK LAKE BLVD SW, OLYMPIA, WA - 98502-5066 (mailing address contact number: 360-357-2544).

Location: 625 Black Lake Blvd Sw, Olympia, WA, 98502-5066
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1811052798
Provider Name
Kenneth D. Common, O.d., P.s.
Credential
Provider Entity Type
Organization
Address
625 Black Lake Blvd Sw, Olympia, WA, 98502-5066
Phone Number
360-357-2544
Fax Number
360-357-6341
Provider Enumeration Date
12/22/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
625 Black Lake Blvd Sw
City
Olympia
State
Washington
Zip
98502-5066
Phone Number
360-357-2544
Fax Number
360-357-6341
person
Provider Business Mailing Address Details
Address
625 Black Lake Blvd Sw
City
Olympia
State
Washington
Zip
98502-5066
Phone Number
360-357-2544
Fax Number
360-357-6341
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
1155 (Washington)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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